CARE HOMES FOR OLDER PEOPLE
Heatherside Scures Hill Nately Scures Basingstoke RG27 9JR Lead Inspector
Annie Billings Unannounced 23.08.05 11:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Heatherside Address Scures Hill Nately Scures Basingstoke RG27 9JR 01256 762233 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Pearl Care (Norwich) Ltd Miss Siobhan Mary Phillips CRH 34 Category(ies) of OP Old age registration, with number of places Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 07.04.05 Brief Description of the Service: Heatherside provides care for up to thirty-four male and female service users over the age of 65 with associated needs of older people. The home is situated on the A30, in the small village of Nately Scures, about 5 miles from Basingstoke. The building is a large modernised Edwardian twostorey property, set in 2 acres of gardens. The gardens are extensive, well maintained and laid mainly to lawn and ample car parking is available at the front of the premises. Heatherside offers thirty-two single bedrooms, of which twenty-eight have an en-suite facility, and one double bedroom without en-suite. A passenger lift provides easy access to the first floor. The home’s communal space comprises of one quiet comfortable lounge, separate dining areas and a large conservatory lounge. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over five hours as part of the normal regulation and inspection programme, and to follow up on progress with issues identified at the last inspection. A partial tour of the premises took place, and records were examined. The inspector also had the opportunity to talk to eleven service users, and four members of staff, in addition to the registered manager, who assisted with the inspection. What the service does well: What has improved since the last inspection?
Progress on redecoration is slow, although since the last inspection two bedrooms, two WCs have been painted, new flooring has been laid in one bathroom and WC and the entrance hall carpet has been replaced. One resident said they were very comfortable with their room and liked the decor, although advised that their family had chosen to provide new furniture. Some equipment within the home has been replaced, including an upgrade to laundry facilities and a replacement hoist. The manager stated that the first residents meeting was to take place in the next week, to discuss plans for a garden party later this year. The intention is to hold these on a regular basis, demonstrating the participation of residents in how the home is run. This was recommended at the last inspection. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Some progress has been made to improve the admission procedure, but the process is not adequately detailed to ensure that all needs will be met. EVIDENCE: Individual pre-admission assessments were available on three files viewed. These were fully completed, signed and dated, Discussion with the manager suggests that some changes have been made to the process following a requirement at the last inspection, however more development is needed to ensure that full assessments are carried out before prospective residents enter the home. One file identifies the need for hoisting for all transfers. No separate moving and handling assessment has been undertaken, to give staff direction on transfers, or to determine the need for one or two carers. This situation leaves a potential risk to the safety of both residents and staff. The manager gave assurances this will be put in place. This will be reviewed at the next inspection.
Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 Care plans continue to be developed, but more detail is required to ensure that staff know how to meet residents needs. Systems for managing medication are appropriate, although the lack of risk assessments for those wishing to self medicate leaves residents at potential risk. EVIDENCE: Care plans viewed identify that some progress has been made since the last inspection to ensure that care plans provide staff with sufficient guidance to meet all residents’ needs, although more work is necessary. One care plan identifies the need for hoist transfers, but does not detail the action to be taken. Others sampled contain phrases for example, “some assistance” and “needs help”, but do not detail what assistance or how to help. The manager gave assurances that care planning will continue to be developed, therefore no requirement has been made. This are will be reassessed at the next inspection. Residents spoken to were keen to praise the staff team, who do their utmost to provide friendly, caring support and encouragement. Comments received included, “They’re marvellous”, “Everyone’s cheerful and friendly” and “They couldn’t do more for you, it’s like a hotel”.
Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 10 Systems for managing medication are good, with evidence available to confirm that all staff have been trained in the safe handling of medication. Discussion with the manager identified that regular pharmacist audits are not undertaken. This has been encouraged to ensure that the systems maintained are in line with best practice. One resident, recently admitted to the home, chooses to self medicate, although no risk assessment had been undertaken. The manager has agreed to put this in place, to ensure the safety of the resident. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 Residents are encouraged to take control over their lives, and remain as independent as possible. EVIDENCE: The manager advised that all residents deal with their own financial affairs with the support of their families. If assistance is required, the manager would refer to the residents care manager for support. All residents said they had been encouraged to bring in personal items when they had been admitted to the home. One recently admitted resident said their family had chosen to bring in new furniture, and the room had been personalised with their own possessions. Residents confirmed they determine their own daily routines as they choose, although support is always available. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Policies and procedures in the home protect residents from abuse. EVIDENCE: Four staff members interviewed had a good awareness of abuse issues, and were aware of the reporting procedures within the home. Training records examined confirmed that several members of staff had received formal training in February 2005, and a further course has been booked for October. The manager stated that no personal allowances are retained on behalf of residents. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 Some improvements to the decor have been made. A number of issues identified within the environment must be addressed to ensure that people are not put at risk and the home is well maintained. EVIDENCE: Since the last inspection the home has continued with their redecoration programme, and two bedrooms and two WCs have been redecorated, new flooring has been laid in one bathroom and WC and a new carpet has been fitted in the entrance hall. Additional laundry equipment has been installed and a new hoist has been purchased. The gardens attracted particular praise from the residents, with immaculately tended lawns and colourful flower displays. A number of areas still require attention, although the manager has given assurances that these will be addressed: Woodwork, particularly along corridor areas, is badly scuffed and chipped. This looks unsightly and does not give a good impression of the home. A hot water pipe outside room 29 remains
Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 14 uncovered. This must be boxed in to ensure the safety of residents. One resident chooses to have their door wedged open day and night. The manager must consult with the fire safety officer, to ensure the home meets fire regulations and to ensure the safety of the resident. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected. EVIDENCE: Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 38 Practices are in place to ensure the home is run in the interests of residents, and to safeguard their health, safety, welfare and financial interests. EVIDENCE: The manager advised that feedback is actively sought from residents and relatives on a one to one basis, although a more formal quality assurance system is under development. This will be reviewed at the next inspection. A residents meeting is being held shortly to discuss the arrangements for a garden party, and it is understood these meetings are to be held on a regular basis, with minutes of the meeting circulated to those not attending, to ensure everyone’s involvement in the running of the home. The manager advised that all residents are encouraged to manage their own finances, with the support of families, and no personal allowances are retained
Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 17 by the home. In the event of additional advice and support, the manager said she would refer to the residents’ care manager. Records examined and care practices observed ensure the health, safety and welfare of the residents. Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x
COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x 3 x x 3 Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Heatherside H54 S49984 Heatherside V241567 230805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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